8歳女児のpit macular syndromeにおける視力変化とOCT所見

Course of visual acuity and findings by optical coherence tomography of pit-macular syndrome in an eight-year-old girl

　8歳女児が3週間前からの左眼視力低下で受診した。7か月前の健康診断では，左右眼とも1.0の矯正視力があった。受診時の矯正視力は右1.2，左0.2であり，左眼に黄斑を中心とする漿液性網膜剝離と，乳頭に乳頭孔（pit）があった。蛍光眼底造影では，pitの部位に初期から後期にかけて過蛍光があり，網膜剝離の部位には色素貯留があった。光干渉断層計（OCT-3）で，網膜外層の網膜分離，中心窩の囊胞形成，700μmを超える漿液性網膜剝離があった。Pit-macular症候群と診断した。家族の希望で治療は行わなかった。6か月後に視力は0.5に改善し，OCTで網膜剝離と中心窩囊胞の残存と網膜分離の改善が認められた。OCTは非侵襲的であり，小児でも網膜の構造を検索することができ，本症候群では視力と関係がある網膜分離の所見を捉えることができた。

　An 8-year-old girl presented with decreased visual acuity in her left eye since 3 weeks before. She had had full visual acuity during health check 7months before. When seen by us,her corrected visual acuity was 1.2 right and 0.2 left. The left eye showed serous retinal detachment in the macular area and pit in the optic disc. Fluorescein angiography showed hyperfluorescence in the pit area throughout the phases. The area of retinal detachment showed dye pooling. Optical coherence tomography（OCT-3）showed retinoschisis in the outer retinal layer,cysts in the fovea,and serous retinal detachment of over 700μm in height. We diagnosed the left eye with pit-macular syndrome. The patient received no treatment by the wish of parents. The visual acuity improved to 0.5 6months later. OCT showed regression of retinoschisis in spite of persistent retinal detachment and foveal cysts. OCT was noninvasive and was useful in the detection of retinoschisis in this child.